Smits M, Rutten M, Schepers L, Giesen P
Radboudumc, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen.
Ned Tijdschr Geneeskd. 2017;161:D1601.
There is a trend for General Practitioner Cooperatives (GPCs) to co-locate with emergency departments (EDs) of hospitals at Emergency Care Access Points (ECAPs), where the GPCs generally conduct triage and treat a large part of self-referrals who would have gone to the ED by themselves in the past. We have examined patient and care characteristics of self-referrals at ECAPs where triage was conducted by GPCs, also to determine the percentage of self-referrals being referred to the ED.
Retrospective cross-sectional observational study.
Descriptive analyses of routine registration data from self-referrals of five ECAPs (n = 20.451). Patient age, gender, arrival time, urgency, diagnosis and referral were analysed.
Of the self-referrals, 57.9% was male and the mean age was 32.7 years. The number of self-referrals per hour was highest during weekends, particularly between 11 a.m. and 5 p.m. On weekdays, there was a peak between 5 and 9 p.m. Self-referrals were mostly assigned a low-urgency grade (35.7% - U4 or U5) or a mid-urgency grade (49% - U3). Almost half of the self-referrals had trauma of the locomotor system (28%) or the skin (27.3%). In total, 23% of the patients was referred to the ED.
Self-referred patients at GPCs are typically young, male and have low- to mid-urgency trauma-related problems. Many self-referrals present themselves on weekend days or early weekday evenings. Over three quarters of these patients can be treated by the GPCs, without referral to the ED. This reduces the workload at the ED.
全科医生合作社（GPC）有与医院急诊科（ED）在紧急护理接入点（ECAP）合址办公的趋势，在这些地点，GPC通常对大量过去会自行前往急诊科的自我转诊患者进行分诊和治疗。我们研究了由GPC进行分诊的ECAP处自我转诊患者的特征及护理情况，还确定了被转诊至急诊科的自我转诊患者的比例。
回顾性横断面观察研究。
对五个ECAP（n = 20451）自我转诊患者的常规登记数据进行描述性分析。分析了患者的年龄、性别、就诊时间、紧急程度、诊断和转诊情况。
在自我转诊患者中，57.9%为男性，平均年龄为32.7岁。每小时自我转诊患者数量在周末最高，尤其是上午11点至下午5点之间。在工作日，下午5点至9点有一个高峰。自我转诊患者大多被评定为低紧急等级（35.7% - U4或U5）或中等紧急等级（49% - U3）。几乎一半的自我转诊患者有运动系统创伤（28%）或皮肤创伤（27.3%）。总共有23%的患者被转诊至急诊科。
GPC的自我转诊患者通常为年轻男性，有低至中等紧急程度的创伤相关问题。许多自我转诊患者在周末或工作日傍晚前来就诊。这些患者中超过四分之三可由GPC治疗，无需转诊至急诊科。这减轻了急诊科的工作量。
